心功能不全合并冠状动脉慢性完全闭塞患者行介入治疗开通后对心功能的影响分析

Influence of successful revascularization by percutaneous coronary intervention on heart function of patients with heart dysfunction combined with chronic total occlusion

目的观察心功能不全合并冠状动脉慢性完全闭塞（CTO）患者行经皮冠状动脉介入治疗（PCI）开通后对心功能的影响。方法选择272例心功能不全合并CTO患者，按PCI结果分为PCI开通成功组（246例）与PCI开通失败组（26例）。术后6个月复查心脏超声，对比分析两组患者心功能的差别。结果开通成功组与开通失败组分别有229例及24例患者于术后6个月复查心脏超声。开通失败组术后6个月左室射血分数（LVEF）和左室舒张末期容积指数（LVEDVI）与术前比较差异无统计学意义（P〉0．05），开通成功组术后6个月LVEF和LVEDVI均较术前及开通失败组术后6个月明显改善[（51±5）％比（43±6）％和（45±2）％、（77±13）ml／m。比（86±12）ml／m。和（86±10）ml／m2,P〈0．05]。开通失败组术后6个月心功能分级与术前比较差异无统计学意义（P〉0．05）；开通成功组术后6个月心功能分级较术前和开通失败组术后6个月有明显改善（P〈0．05）。结论心功能不全合并CTO患者行PCI开通后心功能明显改善。

Objective To evaluate the influence of successful revascularization by percutaneous coronary intervention （PCI） on heart function of patients with heart dysfunction combined with chronic total occlusion （CTO）. Methods The clinical data of 272 patients with heart dysfunction combined with CTO were analyzed. The patients were divided into PCI success group （246 cases） and PCI failure group （26 cases） respectively according to the results of PCI. Six months after PCI,the patients underwent cardiac ultrasound examination to compare the heart function between the two groups. Results Cardiac ultrasound examination was successfully performed in 229 patients in PCI success group and 24 patients in PCI failure group at 6 months after PCI. The left ventricular ejection fraction （LVEF） and left ventficular end-diastolic volume index （LVEDVI） showed no significant difference in PCI failure group at 6 months after PCI compared with that before PCI （P 〉 0.05）. In PCI success group,LVEF and LVEDVI were significantly increased at 6 months after PCI compared with that before PCI and compared with that in PCI failure group at 6 months after PCI[ （51 ± 5）% vs. （43±6）% and （45 ±2）%, （77 ± 13） ml/m2 vs. （86 ± 12） ml/m2 and （86 ＋ 10） ml/m2,P〈 0.05 ]. The cardiac functional grading in PCI failure group had no significant difference compared with that before PCI （P 〉 0.05）,but in PCI success group it had significant difference compared with that before PCI and compared with that in PCI failure group at 6 months after PCI （P 〈0.05）. Conclusion Successful revascularization by PCI can improve heart function in patients with heart dysfunction combined with CTO.